Provider Demographics
NPI:1871296673
Name:OPUS GENOMICS
Entity type:Organization
Organization Name:OPUS GENOMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVNI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-439-2248
Mailing Address - Street 1:319 S 43RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4017
Mailing Address - Country:US
Mailing Address - Phone:215-439-2248
Mailing Address - Fax:
Practice Address - Street 1:5110 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1143
Practice Address - Country:US
Practice Address - Phone:215-439-2248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory